The Impact of Potentially Traumatic Perinatal Complications on Postpartum Psychological Distress and Cardiometabolic Risk: Implications for Women's Heart Health.

Abstract

Objective: Perinatal complications are well-documented cardiovascular disease risk factors. However, the potential for these complications to be psychologically traumatic due to their life-threatening nature-and their association with postpartum psychological distress and cardiometabolic risk-remains underexplored. This gap is important, as perinatal complications, trauma and related distress, and cardiometabolic risk factors are independently linked to cardiovascular disease and may have a compounded impact when co-occurring.

Methods: Data were analyzed from 2510 predominantly low-income, racially and ethnically diverse postpartum women. We reviewed medical charts and interviews at 1 month postpartum to identify potentially traumatic perinatal complications, defined as severe or life-threatening complications during pregnancy, labor, delivery, and the postnatal period (up to 2 weeks after birth) affecting the mother or newborn. Postpartum psychological distress, including symptoms of depression, anhedonia, and anxiety, was assessed at 1 and 6 months postpartum, with posttraumatic stress disorder symptoms assessed at 6 months postpartum. Composite indices of cardiometabolic risk were calculated at 6 and 12 months postpartum.

Results: A range of potentially traumatic complications was identified, with 21% of women experiencing a life-threatening complication affecting mothers or newborns. The presence of complications was significantly positively associated with psychological distress, including depressive and anxiety symptoms, at 1 month postpartum. No significant associations were observed for distress at 6 months postpartum. The presence of complications was also significantly positively associated with cardiometabolic risk scores at 6 and 12 months postpartum.

Conclusions: Potentially traumatic pregnancy complications are prevalent and correlate with postpartum psychological distress and cardiometabolic risk, with implications for maternal cardiovascular health.